Serum hepatitis B virus DNA before liver transplantation correlates with HBV reinfection rate even under successful low-dose hepatitis B immunoglobulin prophylaxisReportar como inadecuado




Serum hepatitis B virus DNA before liver transplantation correlates with HBV reinfection rate even under successful low-dose hepatitis B immunoglobulin prophylaxis - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Hepatology International

, Volume 5, Issue 4, pp 918–926

First Online: 25 March 2011Received: 20 August 2010Accepted: 28 February 2011

Abstract

PurposeThe combination of hepatitis B immunoglobulin HBIg and nucleostide analogues has been accepted as the best treatment to control hepatitis B recurrence after orthotopic liver transplantation OLT. However, the optimal dose of HBIg remains unclear. We have previously reported that high-dose HBIg in the early period followed by low-dose HBIg with nucleostide analogues offers reliable and cost-effective control of hepatitis B recurrence. The aim of this study was to investigate intrahepatic hepatitis B virus HBV reinfection status with our clinically successful protocol.

MethodsWe quantified levels of intrahepatic HBV covalently closed circular ccc deoxyribonucleic acid DNA and serum hepatitis B core-related antigen HBcrAg, a new serological marker that can estimate intrahepatic cccDNA levels. Nucleostide analogues were administered in all cases.

ResultsNo patients showed recurrence of hepatitis B surface antigen HBsAg or HBV-DNA. However, HBV, cccDNA, and HBcrAg were positive in 57% and 48% of patients after OLT, respectively. Pre-OLT serum HBV-DNA and HBcrAg levels correlated linearly with post-OLT cccDNA levels r = 0.534, P < 0.05, and r = 0.634, P < 0.05, respectively. High serum HBV-DNA and HBcrAg levels, particularly with >3 log10 copies-mL and >4 log10 IU-mL, respectively, at the time of OLT, were associated with high levels of post-OLT cccDNA. Even with our successful protocol, nearly half of patients showed HBV reinfection.

ConclusionsPatients with high serum HBV-DNA and HBcrAg levels before OLT particularly >3 log10 copies-mL and >4 log10 IU-mL, respectively should be followed with care for HBV recurrence.

KeywordsHepatitis B virus Liver transplantation Recurrence HBcrAg HBV cccDNA  Download fulltext PDF



Autor: Tetsuya Yasunaka - Akinobu Takaki - Takahito Yagi - Yoshiaki Iwasaki - Hiroshi Sadamori - Kazuko Koike - Satoshi Hirohata -

Fuente: https://link.springer.com/article/10.1007/s12072-011-9265-z







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